Ultrasound-assisted endocavitary HDR-Ir192 brachytherapy for unresectable locally advanced uterine cervix carcinoma: retrospective analysis focusing the efficacy and tolerability |
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Authors: | Georgios V. Koukourakis Anthoula Miliadou Ioannis Tsalafoutas Elisavet Geli Anastasia Sotiropoulou-Lontou |
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Affiliation: | 1. Department of Second Radiation Therapy, Saint Savvas Anticancer Institute of Athens, Athens, Greece 2. Department of Medical Physics, Saint Savvas Anticancer Institute of Athens, Athens, Greece 3. Department of First Radiology, Saint Savvas Anticancer Institute of Athens, Athens, Greece
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Abstract: | Purpose To evaluate the impact of uterine cavity’s ultrasound to final selected length of intracavitary tandem. The efficacy and tolerability of external beam radiation plus HDR-Ir192 brachytherapy in our cohort of patients were also estimated. Materials and methods 48 women with locally advanced unresectable uterine cervix carcinoma were treated by HDR-Ir192 endocavitary brachytherapy between January 2007 and January 2009. The median age was 63 (range 38–74). The distribution according to Federation of Gynaecology and Obstetrics (FIGO) staging system was as follows: Stage IIB, 54.16 %; IIIA, 10.4 %; IIIB, 27.0 %; and IVA, 8.3 %. HDR intracavitary brachytherapy was given weekly, beginning at the last week of whole pelvis irradiation, with a dose of 7 Gy to point A for three to four fractions. The median overall treatment time was 50 days (range 42–73 days). The median follow-up time was 2.7 years (range 3 months to 4.9 years). Multivariate analysis was performed using the Cox regression proportional hazards model. Results The complete remission rate after radiotherapy was 93.75 % (45/48). The 5-year actuarial major complication rates (Grade 3 or above) were 6.3 % overall (2.1 % proctitis, 2.1 % cystitis and 2.1 % enteritis). Estimation of the length of uterine cavity by ultrasound helped decisively in the proper placement of the intrauterine tandem inserted. Conclusions Prior knowledge of the length of uterine cavity can facilitate the decisions regarding the proper insertion length of the tandem. Results of cervical cancer treatment with external beam radiation and HDR intracavitary brachytherapy in our hospital are encouraging. |
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